24
Lymph Nodes: cytomorphology and Flow cytometry
Fig. 24.38 Hodgkin's lymphoma, classic Hodgkin and Reed-Sternberg (HRS) cells. Note Golgi staining pattern for CD15 and CD30; note also CD45
staining of surrounding lymphocytes but not the HRS cell (immunostains x OI).
Fig. 24.39 Nodular lymphocyte-predominant Hodgkin's lymphoma, lymphocytic and/or histiocytic cells. Scattered large atypical cells with multiple
nucleoli less prominent than in classic Hodgkin and Reed-Sternberg cells. Small lymphocytes in the background. (A) Papanicolaou x OI, (B) Diff-Quik x OI.
• FCM often nondiagnostic; and
• Important differential diagnosis with LBL, ALCL, reactive
hyperplasia, and nonlymphoid malignancies.
other Hematopoietic neoplasms
Langerhans Cell Histiocytosis
Clinical
M o st cases o f Langerhans cell histiocytosis occur in child hood ,
w ith a p red ilection fo r w h ite males, and it is rare in black
people. Three m a jo r overlapping syndrom es are recognized.191
U n ifo c a l disease presents p red o m in ate ly as isolated e osin o p hilic
g ranulom a o f bones, and less fre q ue ntly lym p h nodes, skin, o r
lung . The unisystem disease u su ally involves one organ system
m u ltifo c a lly, m ost o fte n the skeletal system. The m ultisystem
disease involves a variety o f organs and systems, o fte n the bones,
liver, skin, and lym p h nodes.
Cytomorphology
Fine-needle aspirates are h ig h ly cellular, containing m any iso-
lated Langerhans cells w ith nuclear grooves w ith fine chrom atin,
inconspicuous nucleoli, th in nuclear m em branes, and in tra n u -
clear inclusions. The cytoplasm is u su ally m od erately abundant
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